Walkability and self-rated health in primary care patients

BACKGROUND: The objective of this study was to investigate the relationship between perceived walkability and overall self-rated health among patients who use community-based clinics. METHODS: A cross-sectional survey was distributed to a convenience sample in three community clinics. Forms were completed by 793 clinic patients. Multiple logistic regression analysis was to control for the effects of demographic variables and lifestyles. RESULTS: Perceiving the availability of places to walk was related to better self-rated health. The most important places were work (OR = 3.2), community center (OR = 3.12), park (OR = 2.45) and day care (OR = 2.05). Respondents who said they had zero (OR = .27) or one (OR = .49) place to walk were significantly less healthy than persons who said they had five or more places to walk. CONCLUSION: Persons who perceived that they had no place to walk were significantly less healthy than persons who thought they had at least one place to walk (OR = .39). Support for walkable neighborhoods and education of patients about options for walking may be in the best interests of community medicine patients

Effect of the Mediterranean diet on blood pressure in the PREDIMED trial: results from a randomized controlled trial

BackgroundHypertension can be prevented by adopting healthy dietary patterns. Our aim was to assess the 4-year effect on blood pressure (BP) control of a randomized feeding trial promoting the traditional Mediterranean dietary pattern.MethodsThe PREDIMED primary prevention trial is a randomized, single-blinded, controlled trial conducted in Spanish primary healthcare centers. We recruited 7,447 men (aged 55 to 80 years) and women (aged 60 to 80 years) who had high risk for cardiovascular disease. Participants were assigned to a control group or to one of two Mediterranean diets. The control group received education on following a low-fat diet, while the groups on Mediterranean diets received nutritional education and also free foods; either extra virgin olive oil, or nuts. Trained personnel measured participants’ BP at baseline and once yearly during a 4-year follow-up. We used generalized estimating equations to assess the differences between groups during the follow-up.ResultsThe percentage of participants with controlled BP increased in all three intervention groups (P-value for within-group changes: P<0.001). Participants allocated to either of the two Mediterranean diet groups had significantly lower diastolic BP than the participants in the control group (−1.53 mmHg (95% confidence interval (CI) −2.01 to −1.04) for the Mediterranean diet supplemented with extra virgin olive oil, and −0.65 mmHg (95% CI -1.15 to −0.15) mmHg for the Mediterranean diet supplemented with nuts). No between-group differences in changes of systolic BP were seen.ConclusionsBoth the traditional Mediterranean diet and a low-fat diet exerted beneficial effects on BP and could be part of advice to patients for controlling BP. However, we found lower values of diastolic BP in the two groups promoting the Mediterranean diet with extra virgin olive oil or with nuts than in the control group.Trial registrationCurrent Controlled Trials ISRCTN3573963

Inadequate child supervision: The role of alcohol outlet density, parent drinking behaviors, and social support

Supervisory neglect, or the failure of a caregiver to appropriately supervise a child, is one of the predominant types of neglectful behaviors, with alcohol use being considered a key antecedent to inadequate supervision of children. The current study builds on previous work by examining the role of parental drinking and alcohol outlet densities while controlling for caregiver and child characteristics. Data were obtained from 3,023 participants via a telephone survey from 50 cities throughout California. The telephone survey included items on neglectful parenting practices, drinking behaviors, and socio-demographic characteristics. Densities of alcohol outlets were measured for each of the 202 zip codes in the study. Multilevel Bernoulli models were used to analyze the relationship between four supervisory neglect parenting practices and individual-level and zip code-level variables. In our study, heavy drinking was only significantly related to one of our four outcome variables (leaving a child where he or she may not be safe). The density of on premise alcohol outlets was positively related to leaving a child home alone when an adult should be present. This study demonstrates that discrete relationships exist between alcohol related variables, social support, and specific supervisory neglect subtypes at the ecological and individual levels

Gas storage

International audienceThe continuous increase of energy demands based on fossil fuels in the last years have lead to an increase of greenhouse gases (GHG) emission which strongly contribute to global warming. The main strategies to limit this phenomenon are related to the efficient capture of these gases and to the development of renewable energies sources with limited environmental impact. Particularly, carbon dioxide (CO2) and methane (CH4) are the main constituents of greenhouse gases while hydrogen (H2) is considered an alternative clean energy source to fossil fuels. Therefore, tremendous research to store these gases has been reported by several approaches and among them the physisorption on activated carbons (AC) have received significant attention. Their abundance, low cost and tunable porous structure and chemical functionalities with an existing wide range of precursors that includes bio-wastes make them ideal candidates for gas applications. This chapter presents the recent developments on CH4, CO2 and H2 storage by activated carbons with focus on biomass as precursor materials. An analysis of the main carbon properties affecting the AC's adsorption capacity (i.e. specific surface area, pore size and surface chemistry) is discussed in detail herein

Biopharmaceutical considerations in paediatrics with a view to the evaluation of orally administered drug products – a PEARRL review.

Objectives: In this review, the current biopharmaceutical approaches for evaluation of oral formulation performance in paediatrics are discussed. Key findings: The paediatric gastrointestinal (GI) tract undergoes numerous morphological and physiological changes throughout its development and growth. Some physiological parameters are yet to be investigated, limiting the use of the existing in vitro biopharmaceutical tools to predict the in vivo performance of paediatric formulations. Meals and frequencies of their administration evolve during childhood and affect oral drug absorption. Furthermore, the establishment of a paediatric Biopharmaceutics Classification System (pBCS), based on the adult Biopharmaceutics Classification System (BCS), requires criteria adjustments. The usefulness of computational simulation and modeling for extrapolation of adult data to paediatrics has been confirmed as a tool for predicting drug formulation performance. Despite the great number of successful physiologically based pharmacokinetic models to simulate drug disposition, the simulation of drug absorption from the GI tract is a complicating issue in paediatric populations. Summary: The biopharmaceutics tools for investigation of oral drug absorption in paediatrics need further development, refinement and validation. A combination of in vitro and in silico methods could compensate for the uncertainties accompanying each method on its own

Experimental validation of motor primitive-based control for leg exoskeletons during continuous multi-locomotion tasks

An emerging approach to design locomotion assistive devices deals with reproducing desirable biological principles of human locomotion. In this paper, we present a bio-inspired controller for locomotion assistive devices based on the concept of motor primitives. The weighted combination of artificial primitives results in a set of virtual muscle stimulations. These stimulations then activate a virtual musculoskeletal model producing reference assistive torque profiles for different locomotion tasks (i.e., walking, ascending stairs, and descending stairs). The paper reports the validation of the controller through a set of experiments conducted with healthy participants. The proposed controller was tested for the first time with a unilateral leg exoskeleton assisting hip, knee, and ankle joints by delivering a fraction of the computed reference torques. Importantly, subjects performed a track involving ground-level walking, ascending stairs, and descending stairs and several transitions between these tasks. These experiments highlighted the capability of the controller to provide relevant assistive torques and to effectively handle transitions between the tasks. Subjects displayed a natural interaction with the device. Moreover, they significantly decreased the time needed to complete the track when the assistance was provided, as compared to wearing the device with no assistance